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Posts for category: Oral Health

By John L. Glymph Jr, DMD, PA
February 19, 2019
Category: Oral Health
Tags: oral health   gum disease  
TakeCareofYourGumsTakeCareofYourHeart

At this time of year, hearts are everywhere you look, so it's fitting that February is American Heart Month, a time to focus on cardiovascular health. Cardiovascular disease, which includes heart disease and stroke, is the number one cause of death around the world. But did you know that there's a link between the health of your heart and the health of your mouth?

People with advanced gum disease have a higher risk of having a heart attack, stroke or other cardiovascular event, but what is the connection? For one, oral bacteria found in gum disease can enter the bloodstream, where it has been found in artery-clogging plaque. In addition, untreated gum disease has been determined to worsen high blood pressure, a major contributor to heart attack, stroke and heart failure. One study reported that when gum disease was treated, high blood pressure fell by up to 13 points. But perhaps the most significant common denominator between gum disease and heart disease is inflammation, according to many researchers.

Gum disease is the most common inflammatory disease, affecting nearly 50% of US adults over 30, and 70% of those aged 65 and older, according to the U.S. Centers for Disease Control. The body's inflammation response is a key weapon in fighting infection. However, when there is chronic low-level inflammation such as occurs with untreated periodontal (gum) disease, many adverse health effects can result. In one Harvard University study, chronic inflammation was found to triple the risk of heart attack and double the risk of stroke.

The relationship between gum disease and heart disease is still not completely understood, but there's no denying that a connection exists between the two, so it's worth doing what you can to take care of both your gums and your cardiovascular health. Here are some tips:

  • Eat a heart-healthy—and gum-healthy—diet. A diet low in refined carbohydrates, high in fiber, vitamins C and D, antioxidants and Omega-3s has been shown to lower inflammation, benefitting your gums and your heart.
  • Quit smoking. Using tobacco in any form is a risk factor for developing both gum disease and heart disease.
  • Take care of your oral health. Gum disease can often be prevented—and reversed if caught early—simply with good oral hygiene, so be diligent about brushing your teeth twice a day and flossing once a day.
  • Come in for regular cleanings and checkups. Regular cleanings can help keep your gums healthy, and an examination can determine if you have gum disease. Be sure to tell us about any medical conditions or medications.

As you think about what you can do to take care of your heart health and overall health, don't forget your gums. If you have questions about how to improve your oral health, call us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Good Oral Health Leads to Better Health Overall” and “Carbohydrates Linked to Gum Disease.”

By John L. Glymph Jr, DMD, PA
February 09, 2019
Category: Oral Health
Tags: tooth pain  
WhyYourTeethHurtWillDetermineHowWeTreatThem

Your teeth and gums have a highly sensitive network of nerves. But while it can signal even the most subtle discomfort we may not be able to identify the cause with pinpoint accuracy. As a result, tooth pain could indicate more than one kind of problem including a decayed tooth, root sensitivity, infected gum tissues (like an abscess) or a dying pulp signaled by diseased nerve tissue inside the tooth.

On the other hand, not all tooth pain is the same: it can be dull or sharp, continuous or intermittent. It can feel like a constant, throbbing ache or a sharp wince when you eat or drink something cold or hot, or when you bite down. These differences could point our diagnostic examination in the right direction.

For example, sharp, throbbing pain could indicate deep tooth decay, especially if it suddenly stops. That would likely mean the nerves within the tooth pulp under attack by the infection have died and can no longer transmit pain. The infection, on the other hand is still very much active — this usually requires a root canal treatment (cleaning out the pulp and root canals of diseased and dead tissue and filling the empty spaces) if we’re to save the tooth.

If, however, you’re experiencing sensitivity from temperature or pressure, we could be facing at least a couple of scenarios. For one, your tooth could be fractured. More likely, though, periodontal (gum) disease triggered by bacterial plaque has caused the gum tissues to shrink back (recede) from the affected teeth so that the sensitive dentin layer is exposed and no longer protected by the gum tissue.

If we diagnose gum disease, we’ll need to aggressively remove bacterial plaque from all tooth and gum surfaces. This procedure might require more than one appointment and the possibility of surgery if we encounter deep pockets of infection, especially around the roots. If gum recession is severe you may also need grafting surgery to replace the missing gum tissue or to re-cover the exposed areas of your teeth.

So, knowing the source of tooth pain will direct the course of treatment to follow. With proper treatment, though, the chances are good we can not only restore your teeth and gums to optimum health but we can end the pain.

If you would like more information on treating tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain.”

By John L. Glymph Jr, DMD, PA
January 20, 2019
Category: Oral Health
Tags: jaw pain   tmj disorders  
TrytheConservativePathtoJawPainReliefFirst

If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.

The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.

Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.

TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.

It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.

By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.

TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.

If you would like more information on managing chronic jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”

By John L. Glymph Jr, DMD, PA
January 10, 2019
Category: Oral Health
Tags: oral hygiene  
4WaystoCheckonYourBrushingandFlossingEffectiveness

For most of us, brushing and flossing is a routine part of daily life. But has it become such a routine that you may not be getting the most out of your daily regimen?

First, let's be clear about what you're trying to accomplish with these two important hygiene tasks, which is to remove as much accumulated dental plaque as possible. This thin film of bacteria and food particles is the primary cause for both tooth decay and periodontal (gum) disease.

So how can you tell if you're effectively cleaning dental plaque from your teeth? Here are 4 ways to check your brushing and flossing skills.

The tongue test. Move your tongue across the surface of your teeth, especially at the gum line, immediately after brushing and flossing. "Plaque-free" teeth will feel smooth and slick. If you feel any grittiness, though, you may be missing some plaque.

Floss check. For a similar effect after your daily hygiene take a fresh piece of floss and run it up and down your teeth. If the teeth are clean and you are using un-waxed floss, the floss should "squeak" as you move it up and down.

Disclosing agents. You can also occasionally use a plaque disclosing agent. This product contains a solution you apply to your teeth after brushing and flossing that will dye any leftover plaque a specific color. Disclosing agents are handy for uncovering specific areas that require more of your future hygiene attention. ¬†And don't worry—the dye is temporary and will fade quickly.

Dental visits. For the ultimate test, visit your dentist at least twice a year. Not only can dental cleanings remove hard to reach plaque and calculus (hardened tartar), but your dentist or hygienist can evaluate how well you've been doing. Consider it your "final exam" for oral hygiene!

Be sure to also ask your dental provider for tips and training in better brushing and flossing. Becoming more effective at these critical tasks helps ensure you're keeping your teeth and gums free of disease.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”

By John L. Glymph Jr, DMD, PA
December 31, 2018
Category: Oral Health
Tags: osteoporosis  
ManageYourOsteoporosisMedicationtoAvoidJawboneProblems

Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.

Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.

Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax™, and denosumab or Prolia™. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.

In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.

The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.

Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.

Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.

If you would like more information on the effect of osteoporosis treatment on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Osteoporosis Drugs & Dental Treatment.”